NPIMap

Organization Active NPI

Houchens Express Pharmacy LLC

  • Community/Retail Pharmacy
  • Jasper, IN
National Provider Identifier
1962562199
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
60006383A Issued in IN
Legal business name
HOUCHENS EXPRESS PHARMACY LLC
Practice address
750 W 2ND St
Jasper, IN 47546-2650
Phone
(812) 634-7379
Fax
(812) 482-3216
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Leslie L Bidwell, CPHT
Title
Director of Pharmacy Operations
Phone
(270) 901-3431

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 60006383A IN Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

750 W 2ND St
Jasper, IN 47546-2650

Mailing address

843 Fairview Ave
Bowling Green, KY 42101-4914
Phone (270) 901-3431

Other identifiers 3

IdentifierTypeStateIssuer
1536424OtherOTHER ID NUMBER-COMMERCIAL NUMBER
200397140AMedicaidIN
IN2030OtherINMEDICARE B FLU

Other names 1

  • Sheldon's Express Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140805001028 IN Part B Supplier - Mass Immunization (Roster Biller Only) 6305044850 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntingburg, IN; Jasper, IN; Rockport, IN
O20140926002184 IN DME Supplier - Pharmacy 6305044850 Practice locations: Jasper, IN

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Houchens Express Pharm LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446768000000",
    "number": "1962562199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 FAIRVIEW AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421014914",
            "telephone_number": "270-901-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W 2ND ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462650",
            "telephone_number": "812-634-7379",
            "fax_number": "812-482-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUCHENS EXPRESS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2015-11-06",
        "status": "A",
        "authorized_official_last_name": "BIDWELL",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "270-901-3431",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60006383A",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1536424",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200397140A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B FLU",
            "identifier": "IN2030",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sheldon's Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.